I have a friend who almost died from an Addison's crisis.

She was diagnosed and treated in time, but it is clear she no longer has functioning adrenal glands.
She now takes hydrocortisone every day and will have to do it for the rest of her life.
That's the easy part so far.

The problem is that she is visibly gaining weight by the month. I'm afraid she will turn obese and diabetic very soon, because her doctor tells her to constantly eat carbohydrates to avoid the typical hypoglycemias of Addison's.

Personally I've been Primal for almost a year, bordering sometimes on ketogenic, and have none but the greatest things to say about my experience (and so do a handful of friends and family who have followed me). I definitely know that most available carbs are unsafe and best avoided. But Addison's is a rapid killer condition that is best not to toy with.

Soo... many doubts in my mind.

1 - Is it really necessary to have carbs at hand when you've got Addison's? Can someone with Addison's safely follow a low carb / primal blueprint diet?

2 - Does anyone here have the experience of having Addison's and practising PB/LC for a long time? If so, what are the problems and benefits?

3 - In this specific case, which supplements do you take and why?

And now some techy questions, because I really like to understand the mechanisms behind these problems and solutions.

4 - It is said that cortisol is what triggers the liver to produce blood sugar. So, the typical hypos in Addison's seem to be caused by lack of cortisol to maintain blood sugar level, which could just mean the cortisone dose is too low / badly timed. Two ideas come from here:

4a - too little cortisone will cause frequent hypos, at which point only ingested sugar can "save the day" by compensating for the blood sugar that the liver doesn't release; will this probably lead to non-alcoholic fatty liver disease, since the liver is filled with glycogen and does not release enough glucose into the bloodstream?

4b - too much cortisone will eliminate the hypos, but will it speed up the development of obesity and diabetes because of too much blood sugar?

4c - is cortisol necessary in the metabolism of fatty acids for energy, does she have to depend on it (increase hydrocortisone) to extract energy from a low carb diet?

Thank you very much for your attention, this is a serious issue and time is running against us.